Provider Demographics
NPI:1356816979
Name:COMMUNITY BIRTH GROUP
Entity Type:Organization
Organization Name:COMMUNITY BIRTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-341-8598
Mailing Address - Street 1:902 KITTY HAWK RD # 170487
Mailing Address - Street 2:
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78148-3825
Mailing Address - Country:US
Mailing Address - Phone:800-341-8598
Mailing Address - Fax:
Practice Address - Street 1:617 N 17TH ST STE 200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-3580
Practice Address - Country:US
Practice Address - Phone:800-341-8598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY BIRTH GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-10
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty